Put the joy back into work…

Training Primary Care - NHS - GPs - Put the joy back into work...

The news that the boss of Health Education England is leaving is unlikely to see tears shed.  There will be a collective cheer, if it’s true, that this could be the inflection point for the organisation closing down.

The horrendous state of the workforce, the lack of people was entirely predictable and sits with them.   

It’s true that HEE, a product of the Lansley madness, were dealt a bad hand.  No sooner were they born than they suffered budget cuts, but no worse than the rest of the NHS.

Political fiddling saw the end of the nursing bursary, the extent to which HEE were coconspirators, was never made clear but it is impossible to imagine they were not.

The junior doctor’s strike was the low point where HEE, because of poor leadership decisions, needlessly involved themselves and were described, by a high-court judge as an ‘enforcer’ for the Secretary of State.   Not the role for an arm’s length body.

The appointment of the former CQC, CEO, to the chair, was ill-judged.  Stained with the damage the CQC has done to morale, careers and costs, with no obvious improvements to quality, it’s hard to see the decision in the context of workforce recovery.  

He has, since, been appointed to the board of care-home provider, HC-One, which, I would have thought, an obvious conflict of interest… but no one seems to worry about that sort of thing these days.

None of this sits easily with the NHS.  None of this bodes well for the future of the up-coming People Plan, shelved because of the election.

I doubt we will see it before the new year.  When we do, let’s hope it signals a clear-out at the top; the end of HEE and the birth of a People Department, at NHSI, with someone, nailed-down, accountable.

Recruitment to nursing, at uni, is showing signs of dropping-off and it looks like we could be heading for a time when more nurses are leaving and retiring than we are training.

We don’t want ‘panic’ but we do want a controlled sense of urgency.  I don’t see anything from the HEE that is reassuring.  Their business plan looks ‘comfortable’, business as usual.  It will have to be rewritten when the People Plan finally emerges.

HEE’s budget, big enough to run a small country.  A squandering waste.  They have the panoply of a board, nurse director, finance and all the usual we might expect for running a teaching hospital. 

There are obvious economies to be made.  Dump any thoughts of appointing a new HEE, CEO, saving, probably, all-up, with employment costs, around £200k.  Disband the board and you’ve probably got, going on for, a million.

Return the cash to the front-line where it belongs.  Not in commodious boardrooms.

The people-people, a department of NHSI would be perfectly able to implement its own plan, from an office, sitting somewhere down the corridor.  

Accountable, in line-of-sight and a hell of a lot cheaper. 

Looking at the numbers leaving, only a root and branch change to attitudes to employment will stem the flow.  Taking account of nurse to patient ratios, which border on risky and flirt with downright dangerous, redesigning work, who does it and how, is a massive undertaking and urgent.

There is a huge job to be done to change the working climate, eliminate prejudice and bullying, accelerating training, a serious look at quality and how to achieve it and going for help in a global space.

An organisation, coming with the whiff of regulation and the CQC, whose inspection regimes were the fountain head of much of the bullying the NHS is cursed with, has no place here.

The CQC trounced the careers of good people, for not having enough staff, knowing full well they were impossible to attract.

Relying on career pathways, designed for times when people wanted to join the NHS for life, have to be rethought for a time when millennials want a job and a life and have well paid options and no shift-work.

The NHS has to scrape the old ways off its boots and step into a new future.  

The man who told us; 

‘ These [workforce and other]… pressures cannot be used as an excuse to deliver poor care…. we will use our enforcement powers where necessary, to tackle issues such as staff shortages…’

… doesn’t reassure me that HEE will have the first clue about the rejuvenation of the workforce or how to put the joy back into work.

Have  good weekend.

News and Comment from Roy Lilley

Contact Roy – please use this e-address roy.lilley@nhsmanagers.net

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.